An emergency department (ED), also known as an accident and emergency department (A&E), emergency room (ER), emergency ward (EW) or casualty department, is a medical treatment facility specializing in emergency medicine, the acute care of patients who present without prior appointment; either by their own means or by that of an ambulance. The emergency department is usually found in a hospital or other primary care center.
Brain death is the permanent, irreversible, and complete loss of brain function, which may include cessation of involuntary activity necessary to sustain life. It differs from persistent vegetative state, in which the person is alive and some autonomic functions remain. It is also distinct from comas as long as some brain and bodily activity and function remain, and it is also not the same as the condition locked-in syndrome. A differential diagnosis can medically distinguish these differing conditions.
Intensive care medicine, also called critical care medicine, is a medical specialty that deals with seriously or critically ill patients who have, are at risk of, or are recovering from conditions that may be life-threatening. It includes providing life support, invasive monitoring techniques, resuscitation, and end-of-life care. Doctors in this specialty are often called intensive care physicians, critical care physicians, or intensivists.
Multiple organ dysfunction syndrome (MODS) is altered organ function in an acutely ill patient requiring immediate medical intervention.
Family medicine is a medical specialty within primary care that provides continuing and comprehensive health care for the individual and family across all ages, genders, diseases, and parts of the body. The specialist, who is usually a primary care physician, is named a family physician. It is often referred to as general practice and a practitioner as a general practitioner. Historically, their role was once performed by any doctor with qualifications from a medical school and who works in the community. However, since the 1950s, family medicine / general practice has become a specialty in its own right, with specific training requirements tailored to each country. The names of the specialty emphasize its holistic nature and/or its roots in the family. It is based on knowledge of the patient in the context of the family and the community, focusing on disease prevention and health promotion. According to the World Organization of Family Doctors (WONCA), the aim of family medicine is "promoting personal, comprehensive and continuing care for the individual in the context of the family and the community". The issues of values underlying this practice are usually known as primary care ethics.
Non-invasive ventilation (NIV) is the use of breathing support administered through a face mask, nasal mask, or a helmet. Air, usually with added oxygen, is given through the mask under positive pressure; generally the amount of pressure is alternated depending on whether someone is breathing in or out. It is termed "non-invasive" because it is delivered with a mask that is tightly fitted to the face or around the head, but without a need for tracheal intubation. While there are similarities with regard to the interface, NIV is not the same as continuous positive airway pressure (CPAP), which applies a single level of positive airway pressure throughout the whole respiratory cycle; CPAP does not deliver ventilation but is occasionally used in conditions also treated with NIV.
Vital signs are a group of the four to six most crucial medical signs that indicate the status of the body's vital (life-sustaining) functions. These measurements are taken to help assess the general physical health of a person, give clues to possible diseases, and show progress toward recovery. The normal ranges for a person's vital signs vary with age, weight, sex, and overall health.
The respiratory rate is the rate at which breathing occurs; it is set and controlled by the respiratory center of the brain. A person's respiratory rate is usually measured in breaths per minute.
Acute medicine, also known as acute internal medicine (AIM), is a specialty within internal medicine concerned with the immediate and early specialist management of adult patients with a wide range of medical conditions who present in hospital as emergencies. It developed in the United Kingdom in the early 2000s as a dedicated field of medicine, together with the establishment of acute medical units in numerous hospitals. Acute medicine is distinct from the broader field of emergency medicine, which is concerned with the management of all people attending the emergency department, not just those with internal medicine diagnoses.
An intensive care unit (ICU), also known as an intensive therapy unit or intensive treatment unit (ITU) or critical care unit (CCU), is a special department of a hospital or health care facility that provides intensive care medicine.
Neurocritical care is a medical field that treats life-threatening diseases of the nervous system and identifies, prevents, and treats secondary brain injury.
A pediatric intensive care unit, usually abbreviated to PICU, is an area within a hospital specializing in the care of critically ill infants, children, teenagers, and young adults aged 0–21. A PICU is typically directed by one or more pediatric intensivists or PICU consultants and staffed by doctors, nurses, and respiratory therapists who are specially trained and experienced in pediatric intensive care. The unit may also have nurse practitioners, physician assistants, physiotherapists, social workers, child life specialists, and clerks on staff, although this varies widely depending on geographic location. The ratio of professionals to patients is generally higher than in other areas of the hospital, reflecting the acuity of PICU patients and the risk of life-threatening complications. Complex technology and equipment is often in use, particularly mechanical ventilators and patient monitoring systems. Consequently, PICUs have a larger operating budget than many other departments within the hospital.
Vital Sign Alert System is an alert system designed by nurses at Sentara Norfolk General Hospital in Norfolk, Virginia. The alert system, which replaced an ineffective early warning scoring (EWS) system, is a unique creation designed specifically to enhance patient monitoring on medical–surgical and step-down nursing units without increasing the nurse's workload.
A rapid response system (RRS) is a system implemented in many hospitals designed to identify and respond to patients with early signs of clinical deterioration on non-intensive care units with the goal of preventing respiratory or cardiac arrest. A rapid response system consists of two clinical components, an afferent component, an efferent component, and two organizational components – process improvement and administrative.
Pediatric early warning signs (PEWS) are clinical manifestations that indicate rapid deterioration in pediatric patients, infancy to adolescence. A PEWS score or PEWS system refers to assessment tools that incorporate the clinical manifestations that have the greatest impact on patient outcome.
Respiratory compromise describes a deterioration in respiratory function with a high likelihood of rapid progression to respiratory failure and death. Respiratory failure occurs when inadequate gas exchange by the respiratory system occurs, with a low oxygen level or a high carbon dioxide level.
Critical emergency medicine (CREM) refers to the acute medical care of patients who have medical emergencies that pose an immediate threat to life, irrespective of location. In particular, the term is used to describe the role of anaesthesiologists in providing such care.
The 4 'A's Test (4AT) is a bedside medical scale used to help determine if a person has positive signs for delirium. The 4AT also includes cognitive test items, making it suitable also for use as a rapid test for cognitive impairment.
ReSPECT stands for Recommended Summary Plan for Emergency Care and Treatment. It is an emergency care and treatment plan (ECTP) used in parts of the United Kingdom, in which personalized recommendations for future emergency clinical care and treatment are created through discussion between health care professionals and a person. These recommendations are then documented on a ReSPECT form.
Jane Eddleston is a British medical doctor, professor and critical care consultant at Manchester Royal Infirmary. In 2022 she became the first woman doctor to win the Faculty of Intensive Care Medicine Gold Medal.
